Primary bone cancer is rare, making up around 0.2 percent of all cancers, according to the American Society of Clinical Oncology. Researchers say the onset could be linked to hereditary factors, but a specific cause is not known. The majority of bone tumors are noncancerous. In many cases, when cancer is found in the bone it is secondary — the tumors spread or metastasized from somewhere else and are thus not categorized as bone cancer. Bone cancer, or cancer that has reached the bones, has a variety of symptoms.
Pain is usually the first symptom of bone cancer. Initially, it will be mild and intermittent, often occurring at night or after engaging in physical activity. Over-the-counter medications can usually ease the pain. Over time, however, sensation increases as the disease progresses, eventually becoming a persistent ache. Describing the type of pain as aching, stabbing, throbbing, or burning will help a physician prescribe the right pain relief medications and may help diagnosis.
Tingling, Numbness, or a Burning Sensation
When bone cancer affects the nerves inside the bone, individuals describe a tingling, numb, or burning sensation. Nerve pain can be difficult to describe to a physician because it is unlike the usual types of pain. Bone cancer disrupts the normal activity of bone cells, irritating the interior nerves, injuring the nerve fibers, and increasing nerve sensitivity. Oncologists say that once the tumors interact with the nerves inside the bone, the tumor size increases, worsening these symptoms.
Joint Stiffness and Swelling
Bone cancers often develop near or in a joint in the upper arms or legs. Not only does the area around the joint become tender, but the tumor also causes stiffness, which affects the range of motion. Swelling and redness then develop in the area where the pain first developed, usually several weeks later. The individual may notice a lump or mass near the area as well. A physician will check the area for swelling and tenderness and changes in the surrounding skin.
Weakened Bones and Fractures
In most cases, bone tumors develop in the long bones of the upper arms and legs, and the pelvis. The tumors are usually benign but can be malignant. Cancer weakens the bone where the tumor exists and may cause fractures. Some individuals develop a noticeable limp or experience a sudden onset of severe pain in a bone that was previously sore, and this could be a sign of bone cancer. In some cases, x-rays for other conditions such as sprained ankles or knee injuries uncover benign tumors. Fractures in cancer-weakened bones can occur next to or through the bone tumor itself.
Low Back Pain
Bone cancer occurring in the pelvis may cause lower back pain and sciatica. Back pain is a widespread issue for adults, and this can delay a diagnosis of pelvic bone cancer. Individuals over the age of 45 are the demographic most commonly diagnosed with pelvic cancer, and diagnosis is often preceded by painful symptoms that last longer than a month. Affected people develop a sudden onset of back pain or sciatica that occurs primarily at night and becomes increasingly worse and unresponsive to changes in position or bed rest. Because there is no traumatic injury, most therapies to treat back pain are ineffective.
Most people with cancer contract a fever at some point. Although fever is rarely an early sign of bone cancer, it is a sign that the body is fighting an infection or illness. If cancer affects the immune system, it is harder for the body to fight off the infection. Fevers may signify that cancer has spread or is in an advanced stage. If pain accompanies the fever, or if it exceeds 103 F, seek medical attention.
Fatigue leaves people feeling exhausted after the simplest activities, and sleep does not improve the condition. Fatigue is an early symptom of most cancers, including bone cancer. Pain levels and anemia contribute to fatigue. However, medical professionals believe that anemia is directly related to the effects cancer has on the central nervous system, muscle-energy metabolism, and circadian rhythms. Poor nutrition can also contribute to fatigue in people with bone cancer.
Some types of cancer cause night sweats, medically known as sleep hyperhidrosis. Overheating during sleep does not cause night sweats. Researchers believe the symptom has a connection with the hormonal changes that occur when diseases such as bone cancer affect the body. Night sweats could be the body’s attempt to fight off cancer or a reaction to stress or anxiety. Fevers can also lead to sweating.
Loss of Appetite and Weight Loss
Another sign of bone cancer is the unintended loss of ten pounds or more. Weight changes and muscle loss are common cancer symptoms. Research shows that the body produces substances called cytokines, proteins created by both immune and non-immune cells, to fight off cancer. The production of cytokines causes a decrease in appetite, which leads to poor nutrition in addition to weight and muscle loss. Cachexia is a condition that causes extreme weight loss and muscle wasting, and is commonly seen in advanced cases of cancer.
Bone cancer affecting the bone marrow may cause anemia, the lack of a healthy level of red blood cells or hemoglobin. Cancer interferes with the production of red blood cells, and low levels of hemoglobin prevent the body from getting the oxygen it needs. Symptoms of anemia include fatigue and weakness, shortness of breath, headaches, chest pains, irregular heartbeats, and lightheadedness. A physician can test for red blood cell levels using a complete blood count (CBC) test.